Thursday, April 4, 2013

Development at 24 months

Second Birthday: Development Specifics

I am always a little surprised when we go to our well baby visit and the nurse begins asking developmental questions. I am just a little surprised that our file is not somehow flagged for a little sensitivity in such matters, but at the same time I don’t mind at all; I like to hear the questions. This past time I was pleased by all the affirmative answers I was able to give. Is she using more than twenty words? Yes. Can she spoon-feed with minimal spillage? Yes. (We actually *just* began to work on this, and to my surprised she did pretty well from the beginning). Follows two-part instructions? Yep. Names familiar objects in picture books? Incessantly. Uses pronouns? She’s just beginning to use me/my/mine and that’s it so far. Strings two words together? Yes! Runs well, seldom falls? Ha. Shows empathy? Um... not really (a remnant of SPD?). I realize that positive answers to these questions hardly qualify one for Mensa, but it's still exciting when she can mostly keep up with certain expectations.

I've been curious about Juliana's ever-expanding vocabulary and I recently began compiling a list of words that she says. Her comprehensive vocabulary is way, way, way above this and I believe is mostly on par with other children her age. She’s sharp. She gets it. I have to be careful what I say, because she is always paying attention. Her speech is impressive, I think, given the challenges that she faces. Those challenges are namely low muscle tone and a high arched palate that makes many speech sounds difficult. We have just recently visited a craniofacial doctor to evaluate her palate for a potential submucosal cleft and I am happy to report this is not an issue for Juliana. (It is always a relief to have one less issue to deal with.) However she is very constricted and it was advised that we look into a palate expander - something that I have wanted to do, anyway. At this point I am not sure if we will have to wait years for this (the doctor mentioned that it was usually necessary for the patient to have their six year old molars in) or if we can find someone who can do this sooner.

Despite these challenges, she says a good number of words (list below) and I know that there are more words that’s she saying but I’m just not comprehending yet. She also is getting really good at mimicking and attempting to say most any word. Typically the enunciation will be terrible but she will get the right number of syllables when repeating the word back.

Words at 24 months:

All done
Ready, set, go!
Slice and dice (this one is a phrased used in Daddy/Calvin roughhousing)
Stab (another roughhousing phrase)
Thank you
Where are you

Her gross motor skills still lag considerably but she’s making progress on a regular basis. We love watching this! Just two months ago she was barely tolerating weight on her legs. Then quite suddenly, she was willing to stand up if it meant she could look at something interesting. For awhile we would try to help her walk and she would tap her feet on the ground as if she was doing a tap dance. It was the cutest thing and I regret that we never took a video as it was a short-lived stage. She now takes steps and bears weight on each leg as we help her walk. This time I was sure to take a video, because I know that in another month or so we will probably see marked improvement:

Lately I've felt that Juliana experiences a great deal of frustration due to her inability to walk. She knows that she should be upright in order to keep up with other kids and do the things that they are doing, yet she is either stuck on the floor or in my arms, neither of which is enough for her. It's difficult for me too as there are many situations when it's not safe to crawl but it would be safe to walk (rocky or uneven path) or situations where I simply can't bear to watch her crawl for very long (driveway, garage) or situations where it's just a huge mess to allow her to crawl (playground with a mixture of mulch and mud). I do allow and encourage her to crawl as much as possible as it's a really important exercise for both body and brain. But I very much look forward to the day when I can take her outside and watch her toddle around the yard. Calvin experienced a personality change when he began walking (he became much more content) and I expect that the same will be true of Juliana.

Other fun little things she's doing these days: she insists on wiping her face with a napkin after eating, she loves putting dishes in dishwasher, wants to know letter names, loves to be scared by daddy, loves to join in roughhousing. She continues to love books. She loves going to the library. She loves taking walks. Like most toddlers, she wants to be independent but she also simultaneously wants to be glued to mama.

For the time being she still has four therapy sessions a week. I have wanted to cut it down but it simply hasn't been feasible as I am stuck in a catch-22 with Medicaid: any fewer sessions and she loses it. Medicaid pays for 50% of her therapy costs and any medical bills. This will certainly take serious evaluation in the coming months, especially as Calvin begins kindergarten this fall and we become more serious about our homeschooling efforts. I think that both of them deserve some normalcy and balance in their lives, and that's what we'll attempt to find.